Provider Demographics
NPI:1588990659
Name:LEVERING, ELIZABETH RAE (LPN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RAE
Last Name:LEVERING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 WEST BROWN STREET
Mailing Address - Street 2:
Mailing Address - City:CCROOKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43731
Mailing Address - Country:US
Mailing Address - Phone:740-982-9131
Mailing Address - Fax:
Practice Address - Street 1:335 W BROWN ST
Practice Address - Street 2:
Practice Address - City:CROOKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43731-1024
Practice Address - Country:US
Practice Address - Phone:740-982-9131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH123479164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse